Apply for a Buddy - Participant Intake Form

Effective communication and information sharing between parents or caregivers and recreation providers is essential for creating an inclusive and safe environment.
The information collected supports our staff in preparing programs and the environment to meet the unique needs of each participant.
This intake form is confidential and will only be shared with staff and volunteers who work directly with the participant.
Upon receiving the form, our team reviews it carefully to ensure your buddy has the appropriate training and skills to provide a positive and successful experience for the participant.

Please note: When filling out this form, make sure your answers are as descriptive as possible. This will eliminate any additional follow-up phone calls which would delay the approval process.

By enrolling my child in the Buddy Program, I acknowledge that the role of a Buddy is to provide general support and encouragement to help my child participate in camp activities to the best of their ability. I understand that Buddies are not personal care attendants or behavioral interventionists and that their support is intended to foster inclusion within a group setting rather than provide one-on-one specialized care.

What a Buddy Can Do:

Encouragement& Engagment - Help participants feel comfortable, make friends, and participate in activities.

Guidance & Transitions - Assist with navigating program routines, schedules, and transitions between activities.

Behaviour Support - Use redirection techniques, positive reinforcement, and encouragement to help participants manage challenges.

Safety Awareness - Monitor and promot safe participation in all activities.

Communication Support - Help participants express their needs and interact with peers and staff.

Program Adaptions - Help motify activites as needed to ensure inclusion and participations.

What a Buddy Cannot Do:

Procide Hands-On Physical Support - No lifts, transfers, or physical interventions.

Administer Medication - Families must make alternative arrangements for medication administration.

Assist with Toileting or Personal Care - Buddies can provide verbal reminders, but cannot physically assist with changing, toileting, or hygiene needs.

Handle Aggressive or Unsafe Behaviour Alone - If a participant displays behaviours that pose a rish to themselves or others, staff will follow the Behaviour Procedure and contact parents / guardians if necessary.

Act as a One-on-One Therapist or Specialist - Buddies are not certified as Child and Youth Workers, Educational Assistants, Personal Support Workers, or Behavioural Therapists.

By enrolling this participant in the Buddy Program, I acknowledge the above roles of a Buddy and the support a Buddy can and cannot provide:

I understand and acknowledge the support a Buddy can provide.

The Buddy Program Costs

Day Camps

Week 1: Free Buddy Support + the cost of the camp.

Week 2 & 3: $375 for Buddy support + the cost of the camp.

Recreation Programs

$80 for Buddy Support + the cost of the program.

Below are the costs for a Buddy by program. Please indicate where you are sourcing your funding:

I have external funding (i.e. Empower Simcoe, Catulpa etc,) for the Buddy Program.

I will require a sponsorship for the Buddy Program (available for day camp registration only).

I am able to pay the full cost of the Buddy Program.

Caregiver/Outside Agency Information

Please let us know if you are requesting a buddy for yourself, as a caregiver, or if you're representing an outside agency:

I am an outside agency.

I am a caregiver/parent/guardian requesting inclusion on behalf of a participant.

I am requesting inclusion services for myself.

First and Last Name of Caregiver/Parent/Guardian and/or Individual (if requesting support for yourself):

Phone Number of the Caregiver/Parent/Guardian/Agency:

Email Address of the Caregiver/Parent/Guardian/Agency:

Participant's First and Last Name

Participant's Phone Number (if different than the Caregiver/Parent/Guardian/Agency:

Participant's Street Name and Number:

City (of the participant):

Province (of the participant):

Postal Code (of the participant):

Participant's Date of Birth

Participant's Diagnosis (if applicable)

Any additional allergies, medical conditions or limitations:

Medications

What program is the participant interested in attending?

Dance

Sports

Fitness

Camps

Aquatics

Other